地塞米松玻璃体内植入剂Ozurdex治疗视网膜静脉阻塞继发黄斑水肿的短期疗效

目的通过比较地塞米松玻璃体内植入剂Ozurdex与雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿(macular edema secondary to retinal vein occlusion,RVO-ME)的情况,评估Ozurdex的短期临床疗效。方法回顾性分析2018年1月至12月就诊于佛山市第二人民医院眼科中心的RVO-ME患者(42例42眼)的临床资料。将其分为DEX组(11例)和抗VEGF组(31例)。观察两组患者治疗前后的最佳矫正视力(best corrected visual acuity,BCVA)、中央视网膜厚度(central retinal thickness,CRT)、药效持续时间(复发率)、不良反应等。结果 DEX组治疗后1个月、2个月、3个月和4个月的BCVA与治疗前比较差异均有统计学意义(均为P<0.05),治疗后6个月与治疗前比较差异无统计学意义(P=0.054);DEX组治疗后1个月、2个月、3个月、4个月和6个月CRT与治疗前比较差异均有统计学意义(均为P<0.05)。抗VEGF组治疗后1个月BCVA、CRT与治疗前比较差异均有统计学意义(均为P<0.05)。治疗后1个月,DEX组与抗VEGF组间BCVA、CRT比较差异均无统计学意义(均为P>0.05)。DEX组内、抗VEGF组内及两者间视网膜分支静脉阻塞与视网膜中央静脉阻塞的BCVA、CRT比较除DXE组治疗后1个月CRT外,差异均无统计学意义(均为P>0.05)。DEX组的药效持续时间为3~4个月,抗VEGF组的药效持续时间<2个月。DEX组的高眼压发生率较抗VEGF组高,差异有统计学意义(P=0.004)。结论 Ozurdex在治疗RVO-ME上有明显的短期疗效,维持时间为3~4个月(少于6个月)。眼压仍是其需密切监控的主要不良反应。

The short-term efficacy of Ozurdex for macular edema secondary to retinal vein occlusion

Objective　To evaluate the short-term clinical efficacy of Ozurdex by comparing intravitreal injection of Ozurdex with ranibizumab in the treatment of macular edema secondary to retinal vein occlusion (RVO-ME).Methods　The clinical data of forty-two eyes of 42 RVO-ME patients who were admitted to the Department of Ophthalmology of the Second People’s Hospital of Foshan City from January to December 2018 were retrospectively analyzed.They were divided into two groups:DEX group with 11 patients and anti-VEGF group with 31 patients.The best corrected visual acuity(BCVA),central retinal thickness (CRT),duration of drug efficacy (recurrence rate),and adverse reactions of the two groups were observed before and after treatment.Results　The differences of BCVA at 1 month,2 months,3 months and 4 months after treatment in the DEX group were statistically significant than that before treatment (all P<0.05),while there was no statistical significance at 6 months after treatment (P=0.054).There were significant differences of CRT at 1 month,2 months,3 months,4 months and 6 months after treatment in the DEX group than that before treatment(all P<0.05).There were significant differences of BCVA and CRT in the anti-VEGF group at 1 month after treatment than those before treatment (both P<0.05).At 1 month after treatment,there were no significant differences of BCVA and CRT between the DEX group and the anti-VEGF group (both P>0.05).There were no significant differences between branch retinal vein occlusion and central retinal vein occlusion in the DEX group,the anti-VEGF group and between the two groups (all P>0.05),except for the CRT at 1 month after treatment in the DEX group.The duration of efficacy in the DEX group was 3 to 4 months,and the duration of efficacy in the anti-VEGF group was <2 months.The incidence of high intraocular pressure in the DEX group was higher than that in the anti-VEGF group,and the difference was statistically significant(P=0.004).Conclusion　Ozurdex has a significant short-term efficacy in the treatment of RVO-ME for a period of 3 to 4 months (less than 6 months).Intraocular pressure is still the main adverse reaction that needs to be closely monitored.